| NPI | 1780991489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER J BROUILLETTE Administrator 407-895-4737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME76609) |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2010-09-02 |